국소 진동자극이 편마비 뇌졸중 환자의 팔 뻗기 수행에 미치는 영향에 대한 운동학적 분석 Kinematic Analysis in Reaching Depending on the Localized Vibration Duration in Persons With Hemiparetic Stroke원문보기
목적 : 본 연구의 목적은 뇌졸중 환자를 대상으로 환측 상지에 진동자극을 적용했을 때, 팔 뻗기 수행에서 나타나는 팔꿈치 움직임의 운동학적 변화를 관찰하기 위함이다. 연구방법 : 연구 설계는 단일집단 교차실험설계(one-group cross-over trial design)를 사용하였으며, 10명의 만성 뇌졸중 환자를 대상으로 하였다. 대상자의 환측 위팔두갈래근(biceps brachii)에 국소 진동자극을 5분, 10분, 20분 동안 무작위로 70Hz로 적용한 후, 3차원 동작분석 시스템을 통해 팔 뻗기 수행의 운동학적 움직임을 분석하였다. 종속변수에는 팔꿈치 움직임에서 나타나는 최대 각 속도, 최대 각속도까지의 시간, 움직임 단위를 포함하였다. 결과 : 팔 뻗기를 수행함에 있어서 팔꿈치의 움직임은 20분 동안 국소 진동자극을 적용하였을 때 보다 빠르고 부드러워졌으며, 효율적으로 나타났다. 팔꿈치 움직임의 최대 각속도는 증가하였고(p<0.05), 최대 각속도까지의 시간과 운동단위는 유의하게 감소하였다(p<0.05). 결론 : 국소 진동자극은 편마비 뇌졸중 환자가 팔 뻗기 움직임을 수행함에 있어 발생하는 운동학적 구성요소를 향상시킬 수 있는 효과적인 방법일 될 수 있다.
목적 : 본 연구의 목적은 뇌졸중 환자를 대상으로 환측 상지에 진동자극을 적용했을 때, 팔 뻗기 수행에서 나타나는 팔꿈치 움직임의 운동학적 변화를 관찰하기 위함이다. 연구방법 : 연구 설계는 단일집단 교차실험설계(one-group cross-over trial design)를 사용하였으며, 10명의 만성 뇌졸중 환자를 대상으로 하였다. 대상자의 환측 위팔두갈래근(biceps brachii)에 국소 진동자극을 5분, 10분, 20분 동안 무작위로 70Hz로 적용한 후, 3차원 동작분석 시스템을 통해 팔 뻗기 수행의 운동학적 움직임을 분석하였다. 종속변수에는 팔꿈치 움직임에서 나타나는 최대 각 속도, 최대 각속도까지의 시간, 움직임 단위를 포함하였다. 결과 : 팔 뻗기를 수행함에 있어서 팔꿈치의 움직임은 20분 동안 국소 진동자극을 적용하였을 때 보다 빠르고 부드러워졌으며, 효율적으로 나타났다. 팔꿈치 움직임의 최대 각속도는 증가하였고(p<0.05), 최대 각속도까지의 시간과 운동단위는 유의하게 감소하였다(p<0.05). 결론 : 국소 진동자극은 편마비 뇌졸중 환자가 팔 뻗기 움직임을 수행함에 있어 발생하는 운동학적 구성요소를 향상시킬 수 있는 효과적인 방법일 될 수 있다.
Objective : Localized vibration has been shown to have a positive effect on recovery of upper-limb motor function in patients with hemiparetic stroke, but there has been little research on kinematic analysis for qualitative changes in movement. This study investigated kinematic changes in elbow moti...
Objective : Localized vibration has been shown to have a positive effect on recovery of upper-limb motor function in patients with hemiparetic stroke, but there has been little research on kinematic analysis for qualitative changes in movement. This study investigated kinematic changes in elbow motion during reaching after localized vibration in persons with hemiparetic stroke. Methods : This study used a one-group, cross-over trial design. Ten chronic stroke patients randomly received localized vibrations on the affected biceps brachii for 5, 10, or 20 min, at 70 Hz. Kinematic analysis of reaching was measured using a 3-D motion analysis system. Variables included peak angular velocity, time to peak angular velocity, and movement units during elbow motion. Result : Affected side elbow motion during reaching was faster, smoother, and more efficient after 20 min localized vibration. Peak angular velocity increased (p<0.05), and time to peak angular velocity (p<0.05) and the movement unit were significantly decreased (p<0.05) during elbow motion for reaching. Conclusion : Localized vibration can improve kinematic components during reaching motion in persons with hemiparetic stroke.
Objective : Localized vibration has been shown to have a positive effect on recovery of upper-limb motor function in patients with hemiparetic stroke, but there has been little research on kinematic analysis for qualitative changes in movement. This study investigated kinematic changes in elbow motion during reaching after localized vibration in persons with hemiparetic stroke. Methods : This study used a one-group, cross-over trial design. Ten chronic stroke patients randomly received localized vibrations on the affected biceps brachii for 5, 10, or 20 min, at 70 Hz. Kinematic analysis of reaching was measured using a 3-D motion analysis system. Variables included peak angular velocity, time to peak angular velocity, and movement units during elbow motion. Result : Affected side elbow motion during reaching was faster, smoother, and more efficient after 20 min localized vibration. Peak angular velocity increased (p<0.05), and time to peak angular velocity (p<0.05) and the movement unit were significantly decreased (p<0.05) during elbow motion for reaching. Conclusion : Localized vibration can improve kinematic components during reaching motion in persons with hemiparetic stroke.
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제안 방법
All study participants received three localized vibration treatments. Each localized vibration treatment duration was decided randomly and indiscriminately among three options (5 minutes, 10 minutes, and 20 minutes).
Consequently, the present study investigated two aspects of localized vibration treatment: qualitative kinematic changes in reaching of chronic stroke patients depending on the duration of locally applied vibration; and the optimal vibration duration that yields the maximum qualitative changes in reaching.
All study participants received three localized vibration treatments. Each localized vibration treatment duration was decided randomly and indiscriminately among three options (5 minutes, 10 minutes, and 20 minutes). The frequency and intensity were set at 70 Hz and 0.
This study investigated the instantaneous qualitative changes in arm reaching motions in chronic stroke patients after 3 conditions (5 minutes, 10 minutes, and 20 minutes) localized vibration. Furthermore, the study investigated the optimal localized vibration duration. The results showed that a single localized vibration of 20 minutes to the biceps brachii of chronic stroke patients led to significant improvements in reaching peak angular velocity (p=0.
However, one limitation of this study was the low number of study subjects. Furthermore, the study only investigated instantaneous effect after localized vibration and did not provide evidence for the long term effect of these improvements. Consequently, future studies should include more participants and investigate not only the instantaneous, but also the long-term effects of localized vibrations on motor functions in chronic stroke patients.
In this study, the vibrator used acoustic vibration was developed through a joint effort between Yonsei University’s Department of Occupational Therapy and Evosonics.
The present study utilized a one-group cross-over trial design to investigate the optimal localized vibration duration to improve reaching in chronic stroke patients. Study participants were subjected to localized vibrations on their biceps brachii, and qualitative kinematic changes of the reaching were analyzed by using a 3-D motion analysis system. To determine the optimal localized vibration duration, patients were randomly assigned to one of three localized vibration duration groups (5 minutes, 10 minutes, and 20 minutes).
The affected arm was left on the table as a starting point and the unaffected arm was rested comfortably on the participant’s knees. The experiment objective was for the participant to reach out to a target object by using the affected arm(Figure 1). Prior to evaluation, participants practiced the reaching motion twice to ensure that they understood the objective.
The experiment started with each participant sitting at a table that allowed the participant to maintain a 90-degree angle with their knees and elbows. The affected arm was left on the table as a starting point and the unaffected arm was rested comfortably on the participant’s knees.
This study investigated the instantaneous qualitative changes in arm reaching motions in chronic stroke patients after 3 conditions (5 minutes, 10 minutes, and 20 minutes) localized vibration. Furthermore, the study investigated the optimal localized vibration duration.
Study participants were subjected to localized vibrations on their biceps brachii, and qualitative kinematic changes of the reaching were analyzed by using a 3-D motion analysis system. To determine the optimal localized vibration duration, patients were randomly assigned to one of three localized vibration duration groups (5 minutes, 10 minutes, and 20 minutes).
대상 데이터
General study participant characteristics are shown in Table 1. The study consisted of 6 males and 4 females. Of these 10 subjects, 6 had right hemiplegia and 4 had left hemiplegia.
데이터처리
SPSS 21.0 was used for statistical analysis; a Wilcoxon signed-rank test investigated the changes before and after intervention. The statistical significance value was set as p < 0.
이론/모형
Kinematic changes in upper limb motions were measured by using a 3-D motion analysis system (Compact measuring system 10, Zebris Medical GmbH, Isny, Germany). This apparatus consists of a computer, a 1 cm marker that sends ultrasonic signals, a cable adapter that transmits data from the marker, and a measurement detector that detects the ultrasound signal.
성능/효과
041). Consequently, the study results confirmed qualitative improvement in upper limb function as exemplified by the arm reaching motion, and especially, localized vibrations of 70 Hz and 0.2 mm for a 20-minute duration were shown to be the most effective.
2 mm, respectively, based on the results of the precedent studies. The results of this study showed that chronic stroke patients exhibited a significant improvement in arm reaching motion velocity and smoothness after 20 minutes of localized vibration on their affected biceps brachii. Such results indicate that 70 Hz localized vibrations stimulate not only tendons but also muscles.
Furthermore, the study investigated the optimal localized vibration duration. The results showed that a single localized vibration of 20 minutes to the biceps brachii of chronic stroke patients led to significant improvements in reaching peak angular velocity (p=0.028), time to peak angular velocity (p=0.032), and movement unit (p=0.041). Consequently, the study results confirmed qualitative improvement in upper limb function as exemplified by the arm reaching motion, and especially, localized vibrations of 70 Hz and 0.
This study demonstrated that, while kinematic changes in reaching motion velocity, and smoothness differ based on treatment duration, a single administration of localized vibration resulted in instantaneous qualitative improvement in the arm reaching motion of chronic stroke patients. At least 20 minutes of localized vibration treatment at 70 Hz was necessary to qualitatively improve motor function in chronic stroke patients.
후속연구
Furthermore, the study only investigated instantaneous effect after localized vibration and did not provide evidence for the long term effect of these improvements. Consequently, future studies should include more participants and investigate not only the instantaneous, but also the long-term effects of localized vibrations on motor functions in chronic stroke patients.
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